妊娠高血压疾病的发病因素与母婴不良结局的关系

目的 研究妊娠高血压疾病发病相关因素与母婴不良结局的关系。方法 以2013年1月至2015年6月收治的200例妊娠高血压疾病患者为研究对象,收集并整理所有患者病例资料,包括妊娠高血压严重程度、孕周、孕次、分娩方式、合并症、母婴不良结局等,单因素及多因素logistic回归分析妊娠高血压疾病发病因素及分娩方式对母婴不良结局的影响。结果 母婴不良结局:母亲不良结局55例(27.5%),胎儿不良结局48个(21.5%),新生儿不良结局47个(21.3%)。相关性:尿蛋白严重程度与妊娠高血压疾病程度正相关(P<0.05)。单因素及logistic多因素回归分析发现母婴不良结局与妊娠高血压疾病发病孕周、分娩孕周及尿蛋白有关。结论 及时发现并严格控制妊娠高血压疾病及蛋白尿程度,最大限度延长分娩孕周能有效减少母婴不良结局发生。     

Logistic回归的主成分改进方法探讨及其医学应用

研究Logistic回归模型的主成分回归改进方法。在医学研究中,尤其是在流行病的发病因素分析中,应用主成分回归进行多重共线性的改进处理,可以削减自变量观察矩阵之间的多重共线性,建立较为理想的关系模型,提高结果的可靠性;便于医学研究者正确合理的建立Logistic回归模型,处理混杂因素,预测疾病和判别分类。     

腹主动脉弹性与临床指标关系的主成分Logistic回归分析

为探讨腹主动脉硬化的危险因素 ,讨论处理 L ogistic回归模型中多重共线性的方法 ,随机抽取 190例病人 ,按腹主动脉弹性≤ 1mm和 >1mm分为两组 ,92例在腹主动脉弹性≤ 1mm组 ,98例在腹主动脉弹性 >1mm组 ,测定 9个相关临床指标。先用主成分分析方法将 9个相关变量的信息综合 ,提取 9个独立的因子 ,然后用新的因子进行 Logistic回归分析。结果显示 ,应用主成分分析改进后的 Logistic回归模型拟合数据 ,方程的临床意义得到更合理的解释。     

妊娠高血压疾病与孕妇生活习惯关系的临床研究

目的:探讨孕妇生活习惯与妊娠高血压疾病之间的相关性。方法:选择在我院接受治疗的70例患者妊娠高血压疾病且无其他任何妊娠并发症的单胎孕妇患者作为观察组研究对象,选择同期在我院接受检查的妊娠正常者110例作为对照组研究对象,采用调查问卷的方式对两组研究对象进行产后访视调查,了解两组研究对象的年龄、家庭收入、文化程度等一般资料,以及饮食习惯、不良嗜好、体育锻炼、娱乐情况等孕期不良生活习惯和妊娠结局,采用Logistic回归分析对妊娠高血压疾病和孕妇不良生活习惯之间的关系进行分析,比较两组研究对象的妊娠结局。结果:两组孕妇在孕期不良生活习惯方面比较具有统计学差异(P<0.05);Logistic回归分析显示,饮食习惯、不良嗜好、体育锻炼与妊娠期高血压呈显著正相关(P<0.05),娱乐情况与妊娠期高血压未见显著关联性(P>0.05)。观察组孕妇不良妊娠结局发生率明显高于对照组孕妇(P<0.05)。结论:孕期不良生活习惯会增加孕妇妊娠期高血压疾病的发生率,进而增加不良妊娠结局的风险。     

不同程度妊娠高血压综合症对妊娠结局的影响

目的:对比分析不同程度妊娠高血压综合症对妊娠结局的影响。方法:从某院自2013年10月~2014年10月期间所收治的妊娠高血压患者当中选取156例为研究对象,按照妊娠高血压综合症程度的不同将其分为轻度组(67例)、中度组(59例)和重度组(30例),对比分析3组患者早产率、产后出血情况以及胎儿窘迫、新生儿窒息等并发症发生率。结果:3组患者妊娠结局相比较,轻、中度妊娠高血压综合征患者的妊娠结局明显优于重度妊娠高血压综合征患者,比较差异具有统计学意义(P<0.05)。结论:患有妊娠高血压综合症孕妇的妊娠结局和所患疾病的病情程度有关,病情越重,妊娠结局越差。     

重度妊娠高血压疾病终止妊娠时机及方式的探讨

目的探讨重度妊娠高血压疾病终止妊娠的时机和方式对母婴的影响。方法回顾性分析我科33例重度妊娠高血压疾病患者在不同孕周与采取不同方法终止妊娠对母婴结局影响的内在联系。结果重度妊娠高血压疾病33例入院后经药物治疗分别选择适当时机及分娩方式终止妊娠,无1例孕产妇和围产儿死亡,新生儿的窒息率21.2%。结论治疗重度妊娠高血压疾病适时终止妊娠是极重要的手段,剖宫产指征应适当放宽。     

妊娠高血压病人尿蛋白 /肌酐比值、血浆 D-二聚体水平与不良妊娠结局关系研究

目的 探讨妊娠高血压妇女尿蛋白/肌酐比值(urine albumin creatinine ratio,ACR)、血浆D-二聚体水平与不良妊娠结局的关系.方法 选取2015年7月至2018年2月北京市通州区妇幼保健院确诊的妊娠高血压妇女97例进行回顾性研究,根据其妊娠结局分为不良组59例、未出现不良妊娠结局妇女38例(对照组);对比分析两组孕晚期的ACR值、血浆D-二聚体、血压、降压药物应用史、孕次、产次、孕前体质量指数(BMI)等资料,采用logistic回归分析法探讨ACR值、D-二聚体值对妊娠高血压妇女不良妊娠结局的实际影响情况.结果 不良组的ACR值(34.81±9.30)g/mol、D-二聚体值(3.61±1.10)mg/L均高于对照组的(28.77±6.95)g/mol、(2.24±0.87)mg/L(P=0.01,P<0.01);不良组的24 h平均收缩压(24 h SBP)(155.8±8.4)mmHg、24 h平均舒张压(24 h DBP)(102.1±5.1)mmHg、24 h收缩压变异性(24 h SBPV)(0.13±0.05)、24 h舒张压变异性(24 h DBPV)(0.12±0.04)测定值均高于对照组(150.3±8.1)mmHg、(98.1±5.7)mmHg、(0.10±0.04)、(0.09±0.05)(P=0.002,P=0.001,P=0.002,P=0.002);不良组的降压药物应用史、孕前BMI、年龄与对照组差异无统计学意义(P>0.05);不良组的尿蛋白定量、剖宫产率、发病孕周、终止孕周与对照组比较,差异无统计学意义(P>0.05);经logistic回归分析,ACR值、D-二聚体、24 h SBP、24 h DBP、24 h SBPV、24 h DBPV、24 h尿蛋白定量水平增高将增大妊娠高血压妇女不良妊娠结局的风险(P<0.05).结论 妊娠高血压妇女的妊娠结局受到多种因素的影响,ACR、血浆D-二聚体增高是其发生不良妊娠结局的危险因素.     

主成分Logistic回归在早期鉴别卵巢囊肿研究中的应用及其软件开发

目的:应用主成分L og istic回归分析方法对卵巢囊肿进行早期鉴别诊断,并对此实施软件开发以便于门诊辅助诊断,进而提高疾病鉴别诊断的准确性和效率。方法:首先对L og istic回归模型进行共线性诊断,然后筛选出对鉴别卵巢囊肿有统计学意义的检查指标并建立L og istic回归模型,利用该模型对卵巢囊肿进行早期鉴别诊断。程序开发选用delph i 7.0软件。结果:孕次、产次、流产次数间存在着中等程度的共线关系;除孕次、形态、内壁结构外,其余11项指标均纳入模型;回顾性判别符合率为87.86%,前瞻性差别符合率为85.14%,判别效果较好。结论:主成分L og istic回归实现了卵巢囊肿的早期鉴别诊断,开发的软件可以用于门诊辅助诊断。     

不良妊娠结局的重要影响因素分析

目的 分析不良妊娠结局的重要影响因素,提高妊娠质量.方法 回顾性分析436例妊娠妇女,其中316例孕妇存在孕期生殖道感染、孕期糖尿病、孕期被动吸烟和配偶饮酒等危险因素,另120例孕妇无上述危险因素,采用Logistic回归分析导致不良妊娠结局的相关因素.结果 入选孕妇中存在生殖道感染、糖尿病、孕期被动吸烟和配偶饮酒等危险因素的不良妊娠结局发生率分别为5.7％、34.0％、25.8％和17.5％,均高于无上述危险因素的孕妇(2.5％),logistic回归分析显示,导致不良妊娠结局的危险因素中,生殖道感染相对危险度比值比(OR)为3.23、糖尿病OR为5.78、孕期被动吸烟OR为4.88以及配偶饮酒OR为3.85.结论 妊娠期生殖道感染、糖尿病、孕期被动吸烟及配偶饮酒等均与不良妊娠结局相关.     

妊娠期高血压疾病与妊娠结局的相关性研究

目的探讨妊娠期高血压疾病的高危因素,以及妊娠期高血压疾病与妊娠结局之间的关系。方法我院自2009年6月至2011年7月收治妊娠期高血压疾病患者572例,详细统计患者的孕期产检、并发症发生情况、治疗方案等,分期妊娠期高血压疾病的高危因素,讨论妊娠期高血压疾病与妊娠结局之间的关系。结果精神紧张、肥胖、高龄、营养差、双胎等是妊娠期高血压疾病的高危因素。从不产检的66例患者中,其母亲并发症发生率和胎儿并发症发生率明显高于不定期产检的305例患者和定期产检的201例患者,各组之间作比较,差异具有显著性。结论妊娠期高血压疾病与妊娠结局有着密切的联系,加强孕产保健宣教,提倡定期正规产检,能够减少妊娠期并发症的发生,控制妊娠期高血压疾病,改善妊娠结局。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.